What is the proper way of using Eye Drops?

Eye drops are the mainstay of the treatment of eye diseases. Although it is a very common procedure, many people struggle to put eye drops in their eyes correctly and hence may not be getting the effective doses. Besides, as a medication, eye drops can be expensive and wasting them through improper usage could also cost you money. Hence, it is important to know how to administer them properly.
How eye drops work
To put these points in perspective, you need to know first, what happens to the eye-drop when it is instilled into the eye. When you instil a drop into the eye, the natural tendency is for the drop to flow through the tear duct to the nasal cavity and throat (this is the reason that after instilling the eye drops, sometimes you get a bitter taste in the throat), from where they get systemically absorbed. Eye drops continue to be absorbed only while in direct contact with the surface of the eye. Hence, enable the eye drops to remain in contact with the eye for as long as possible to ensure maximum efficacy. To minimise this escape of the eye drop from the eye to the nose, you can follow two simple steps. The first option is to close the eye for two minutes immediately following instillation of any eye drop. This is helpful because, opening and closing the eye activates a pumping mechanism which pushes the tears that are found on the surface of the eye into the tear sac, and from there to the nose. The second option is to gently press against the inner corner of your eyelids beside your nose, to prevent drainage of the tears into the nose and throat by blocking the tear ducts. This will also help in limiting the systemic side effects of the medicine.

How to self-administer eye drops
• When you are applying eye drops yourself, you may find it easier to do so in front of a mirror or lying flat on your back.
• When self-administering the drops, you may want to brace your hand against your face to keep it steady. Avoid accidentally scratching the cornea.
• Look directly at the dispenser tip when positioning it in front of your eye. To keep from blinking, look away from the tip just before you release a drop.

A few other helpful tips
• Do not use the medication if you notice that the tamper-proof seal is broken.
• Read the label properly before using the drop, to check if you are sensitive to any component of the eye drop.
• Be sure to use only the eye drops prescribed for you. Always check the bottle to be sure that it is the right drug. Do not put any medication in your eyes unless the label says ‘ophthalmic’.
• Check your doctor’s prescription clearly for the dosage and also to ensure whether the medication is for both the eyes or for a single eye.
• Do not let anyone else use your drops and also do not use anyone else’s eye drops yourself.
• Always shake the bottle before use, especially if it is a suspension.
• If you have never been taught how to apply eye drops yourself, ask your doctor to teach you to do it rightly.
• Be sure to ask your doctor why you need the eye drops.
• Never exceed the recommended frequency of application. If it is once a day dosage, check whether it is morning or evening, as certain anti-glaucoma medications have greater influence on eye pressure when instilled at night time. It is possible to have corneal damage from administering too many eye drops.
• Always stick to the recommended hour of application each day.
• The ideal time spacing between drops that are taken twice a day is twelve hours.
• Do not wear contact lens while using eye drops unless advised otherwise. Some drugs and preservatives in eye drops can accumulate in soft contact lenses and discolour them. Contact lenses should be removed before applying any eye drops and can be reinserted after about 15 minutes.

To maintain sterility and avoid contamination
• Eye drops are sterile products till you open the bottle.
• Never share your eye drops with anyone else, as there is a great risk of contamination.
• Wash your hands before you start. Avoid touching the tip of the dispenser.
• Avoid touching the eye, the eyelashes, or your fingers with the tip of the bottle. Do not clean or touch the tip of the bottle.
• Close the bottle after use.

Dosage
• Always instil only a single drop into the eye, because the drop size is usually larger than the capacity of the eye to hold the drop. Instilling more than a single drop is akin to wasting it, as the drops will only trickle down and may lead to skin irritation.
• Never exceed the recommended frequency of application. If it is once a day dosage, check whether it is morning or evening, as certain anti-glaucoma medications have greater influence on eye pressure when instilled at night time. It is possible to have corneal damage from administering too many eye drops.
• Always stick to the recommended hour of application each day.
• The ideal time spacing between drops that are taken twice a day is twelve hours.

Multiple eye drops
• If you are using multiple eye medications, ensure at least a five-minute gap between medications to avoid washing away the first drop. It takes five minutes for most of the eye drops to be absorbed into the eye.
• Drops, which come in the form of gel and cream, should always be instilled last because it takes longer for them to be absorbed.

Systemic medications and eye drops
Tell your doctor of all the systemic conditions you are suffering from and the medications you are taking to avoid possible drug interactions and complications.
For instance, certain anti-glaucoma medications can precipitate asthmatic attacks and bradycardia.
• If one is allergic to sulfa group of drugs orally, even instilling topical eye drops containing the same ingredient can trigger severe drug reactions.

Inform your doctor, if you are pregnant or nursing, as the eye drops might affect the term of your pregnancy or harm the baby.

Side effects
Like all medications, eye drops also can cause side effects, but not everyone gets them. You may get a taste of eye drops in your mouth or a sensation that the drops are running down your throat. This is normal, as the tear duct which drains tears to your nose will also drain some of the eye drops to your throat. Some eye drops sting or irritate momentarily. Rarely, some people are allergic to some eye drops. Tell your doctor if eye symptoms become persistently worse. You should see your doctor immediately if you experience
Allergic reactions, like lid swelling with redness and itching of the eye
• Ulcers on the surface of the eye
• Severe pain in the eye
• Blurred or poor vision
• Headache
• Eye infections

Do not use drops longer than recommended, because they can lead to blindness due to glaucoma and cataract in some instances (E.g. topical steroids used in allergic conditions in children).

A few precautions
If you forget to apply a dose, apply it as soon as you remember, unless it is almost time for your next dose in which case, you should miss out the forgotten dose. Then apply your next dose as usual and continue with your normal routine. Do not use a double dose to make up for a forgotten dose.
• Drops should be used as advised by your doctor. Do not stop the drops unless your doctor has told you to. For instance, stopping anti-glaucoma medications prematurely can lead to possible blindness. If you have any further questions on the use of drops, ask your doctor.
• Eye drop usage could cause temporary blurred vision. Do not drive or use precision machinery or instruments before the vision clears. Though the application of eye drops is typically held as an ever-so-common endeavor or procedure, improper application, more often than not, prevents a complete recovery from diagnosed eye ailments.

So, these are some tips to help get the best out of your eye drops by ensuring that they are administered properly and correctly. They might help not only in the general improvement of your quality of life in terms of vision, but also aid in managing your eye related ailments better.